Cutthroat race for medical specializations

Arriving a few minutes late at the Public Health Board can result in years of waiting for young doctors eager to begin a residency program.

by Ellie IsmailidouPhotos: Ellie Ismailidou

Outside the hall, where the medical school of Aristotle University of Thessaloniki’s graduation ceremony is being held, awaits a sea of motorbikes. The drivers are perched on top, their engines revved and ready. They have a determined look in their eyes as they impatiently wait for their passengers to burst out of the hall and jump onto the back to enter the race. This isn’t some kind of stunt or a school tradition…it’s the inevitable aftermath of the medical school graduation ceremony, which has been literally transformed into a Grand Prix motorbike race between the new doctors!

With a bouquet of flowers and her freshly issued medical degree in hand, Maritina Antoniou, races to the local Health Bureau with the help of her lifelong friend, Kostantis Papaioannou.

The starting point is the university graduation hall where the degrees are distributed. The finish line is the local Health Bureau where the new doctors apply for their desired specialization. The prize is a residency spot with as short a waiting period for enrolment as possible, at a time when medical graduates wait in line for up to ten years to begin a specialization. The door bursts open and Maritina Antoniou flies out, her gown billowing behind her. She’s holding a bouquet of flowers in one hand, and her precious, freshly issued degree in the other. Her lifelong friend Kostantis Papaioannou waits on his idling motorbike. Maritina vaults onto the back and they disappear in the blink of an eye.

“It’s no secret that medical students wait for years to begin a residency program after having earned their degrees. What a lot of people don’t know is that the length of the wait is largely determined by the order in which we arrive at the Health Bureau to submit an application. Being five minutes behind your peers in line could translate into as much as an additional year’s wait for a residency position,” Antoniou had explained to me earlier. She was planning on selecting ophthalmology, one of the specializations with the longest waiting lists. Despite the race, she is anything but optimistic about the result. “Even if I get there first, the earliest possible date that I could start the residency program would be in 2020! Unfortunately, given the circumstances I’m seriously considering going abroad to complete my studies,” she concludes.

“An unjust system”

Katerina Eustathopoulou runs on her high heels with her hard earned degree in hand. The first letter of her surname may cost her a few years of waiting for a residency.

Katerina Eustathopoulou runs out of the door a few moments later, tottering on her high heels, clutching her degree in hand. The first letter of her last name didn’t do her any favors. “Diplomas are handed out in alphabetical order and there are a lot of graduates between A and E that will make it to the Health Bureau before me,” she had already explained. Young doctors were either being rewarded or punished by the alphabetical order of their last names, at a time when, in Athens alone, there are almost eight thousand unspecialized doctors awaiting residency. When the registrar’s office realized that the system gave an unfair advantage to the students whose surnames were at the beginning of the alphabet, they decided to handout degrees to three separate alphabetical groups simultaneously. “The system is still unfair because it is not merit based. Random advantage should be unthinkable in the working of a modern state. If there were Board exams the most qualified would earn specialization residencies first, and we would all be motivated to study harder and become even better doctors for our patients,” Efstathopoulou, who plans on pursuing a surgical specialization, added.

The medical students who find themselves at the tail end of the alphabetical groups have come up with a different way to win the race: “There’s no way I could beat the other motorbikes downtown, which is why I decided to drive to the Health Bureau of the neighboring city of Serres. I can floor it on the National Highway and make up the time I’ve lost!” PetrosIordanidisexplains. Because of the order of the first letters of his last name he found himself at the end of the first alphabetical group and gave up hope of getting a good place in the Thessaloniki lineup. Petros managed to be the third person to declare his preferred specialization in Serres, securing his dream of becoming a surgeon someday.

“I lost the race and went to Switzerland”

Ioanna Dihala 'lost' last year's race and ended up obtaining her specialization in Switzerland.

“In last year’s race you could say that I was among the losers,” says Ioanna Dihala laughingly. She graduated from medical school last year but, unfortunately, the alphabetical order of her last name, combined with a motorbike lacking the necessary horsepower, landed her among the last in line where she watched her wait time for a specialization increase by a year. Instead of waiting to begin the program she decided to take action; she took an intensive language course in French and was soon accepted to a Swiss hospital where she is set to begin her residency. Hundreds are forced to flee to hospitals abroad every year, as one out of four Greek doctors is either unemployed or underemployed, according to the Athens Medical Association. “Going abroad was a solution born of necessity, but at the same time it offers an invaluable opportunity to gain experience working in specialized hospitals,” explains Dihala. She is quick to add, however, that the healthcare education system abroad is not a panacea. In hospitals across Europe foreigners (Greek doctors among them) are used to fill empty places that are not being filled by citizens, without any prospects for future security. Ms. Dihala explains that “while there were empty positions available for the first year of the general surgery residency, the third year - which is a specialized gynaecological program - is now full. This means that in two years’ time I could find myself at another dead-end!” she concludes.